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As the number of people who died of the coronavirus in the United States gets close to the 10,000 mark, experts warn that the real number is certainly higher. The official death toll fails to count a lot of people who died and were never tested, meaning the true devastation caused by the virus may never be known.

This is hardly a problem that is exclusive to the United States although the lack of access to tests across the country in the early days of the crisis likely means that a lot of people died but were never counted, notes the Washington Post. That is particularly true in rural areas, where doctors believe many deaths were likely misidentified as influenza or pneumonia, points out the New York Times. And that problem has not ended as more tests have become available because a lot of people who died in their houses or in nursing homes were never tested as some health care officials say using scarce tests on the dead would be a waste of resources. Plus, tests are known to produce false negatives. “We definitely think there are deaths that we have not accounted for,” said Jennifer Nuzzo, a senior scholar at the Johns Hopkins University Center for Health Security.

Although some conspiracy theorists have been pushing the narrative that there is an overcounting of cases because many with COVID-19 died of something else, experts say that is not a real issue. The real problem is the opposite: people who died of the coronavirus but the death was attributed to something else. That is difficult to control because the different standards across the country mean many jurisdictions have their own way of doing things. So experts warn it could take months to consolidate all the numbers and have a more accurate tally, and even then, it will still be subject of debate.

This is a reality that other countries are having to deal with as well. In Italy, for example, the mayor of the northern town of Nembro recently said that the total number of people who died from January to March was four times higher than average for that time of year. And in France the official tally soared after authorities started counting deaths in nursing homes that had been left out of the count. Experts also widely believe that China has undercounted the number of people who died of COVID-19 in Hubei province.